慢性脊髓损伤中的周围神经系统受累
Peripheral nervous system involvement in chronic spinal cord injury.
作者信息
Tankisi Hatice, Pugdahl Kirsten, Rasmussen Mikkel Mylius, Clemmensen Dorte, Rawashdeh Yazan F, Christensen Peter, Krogh Klaus, Fuglsang-Frederiksen Anders
机构信息
Department of Clinical Neurophysiology, Aarhus University Hospital, Nørrebrogade 44, DK-8000, Aarhus C, Denmark.
The Spinal Cord Research Centre, Department of Neurosurgery, Aarhus University Hospital, Aarhus, Denmark.
出版信息
Muscle Nerve. 2015 Dec;52(6):1016-22. doi: 10.1002/mus.24644. Epub 2015 Sep 7.
INTRODUCTION
Upper motor neuron disorders are believed to leave the peripheral nervous system (PNS) intact. In this study we examined whether there is evidence of PNS involvement in spinal cord injury (SCI).
METHODS
Twelve subjects with chronic low cervical or thoracic SCI were included prospectively. Needle electromyography was done in 10 different muscles in each subject bilaterally. Nerve conduction studies (NCS) were conducted in the fibular, tibial, and femoral motor and fibular and sural sensory nerves.
RESULTS
Half the subjects had widespread abnormal spontaneous activity (SA), and the amount of SA correlated inversely with reflex activity and nerve length. Fibular nerve entrapment across the knee was seen in 6 subjects, and sciatic nerve entrapment was seen in 1. Apart from entrapment neuropathies, NCS changes were found predominantly in motor nerves.
CONCLUSION
The presence of widespread electrophysiologic changes outside entrapment sites indicates that SCI has a significant impact on the entire PNS, affecting the motor part predominantly.
引言
上运动神经元疾病被认为不会累及周围神经系统（PNS）。在本研究中，我们探究了是否有证据表明脊髓损伤（SCI）会累及PNS。
方法
前瞻性纳入12例慢性低位颈髓或胸髓损伤患者。对每位受试者双侧10块不同肌肉进行针极肌电图检查。对腓总神经、胫神经、股神经运动支以及腓总神经和腓肠神经感觉支进行神经传导研究（NCS）。
结果
半数受试者存在广泛的异常自发电活动（SA），且SA的量与反射活动及神经长度呈负相关。6例受试者出现膝部腓总神经卡压，1例出现坐骨神经卡压。除卡压性神经病变外，NCS改变主要见于运动神经。
结论
在卡压部位以外存在广泛的电生理改变，表明SCI对整个PNS有显著影响，主要影响运动部分。
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